Traditional Indemnity Plans

Traditional health care insurance plans reimburse a patient (the enrollee or a covered dependent or spouse) according to the provider's bill based on UCRs, that is, usual, customary, and reasonable fees.

For example: A patient sees a physician and pays the charge for the office visit. The patient then files a claim to be reimbursed for the fees paid. (Often, the provider will submit the claim on behalf of the patient as a courtesy.) When the service is covered under the terms of the policy, the patient may expect to receive partial reimbursement for the expenses, usually contingent on the co-insurance being paid by the patient, and the policy deductible amount being met. Typically, there are no limits or restrictions on your choice of a medical service provider.

These plans are typically the most expensive of the various health insurance options and have been dwarfed by managed care in the corporate marketplace.

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